Lessons · Medicine foundations · the ABCDE primary survey
ABCDE: an order of looking, agreed in advance
Airway, Breathing, Circulation, Disability, Exposure: five letters that fix the order in which a person is assessed, so the order is never decided in the moment.
Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.
What it is for
The value of the sequence is that it was agreed before anybody was in a hurry. Everyone in the room knows what comes next, which means the handover, the record and the next pair of hands all line up without anybody negotiating. As a learner, what you owe it is the order, exactly, in the right sequence.
How to think about it
Say the five words in order before you say anything else. Each letter is a looking step: what you can see, hear, feel and measure at that stage. Nothing on this track goes past assessing; what is done about any of it belongs to the clinician responsible for the person.
Worked example
A, Airway: is it clear, and can they speakA person speaking in full sentences is telling you about their airway.
B, Breathing: rate, effort, chest movement, oxygen saturationCounted and measured, not estimated.
C, Circulation: pulse, blood pressure, capillary refillThe three that can be had at the bedside in under a minute.
D, Disability: level of consciousness, pupils, blood glucoseConsciousness is the quickest of the three and the one most often skipped.
E, Exposure: look at the whole person, keeping them covered and warmLast, because it is the step that needs the other four out of the way first.
Your turn
A, B, C and D are Airway, Breathing, Circulation and Disability. Write the word the fifth letter stands for.
A, B, C, D, then .
Solve one, graded on the server
The trap
Starting where the obvious problem is. The whole point of a fixed order is that it is fixed: the loud thing gets the attention it needs when its letter comes, and the quiet thing before it is not stepped over.